HomeMy WebLinkAboutRenewal Request - PetersonPLANNING AND DEVELOPMENT SERVICES DEPARTMENT
PERMIT NUMBER: 2104-0045
BUILDING AND CODE REGULATIONS DIVISION
2300 VIRGIMA AVE
FORT PIERCE, FL 34982
(772) 462-1553 Fax (772) 462-1578
r� �:�u Ir �;� �c� �►�.v� w:� arrlii ��r
ADDRESS: 3605 Crabapple Dr Port St Lucie, FL 34952
I Roberto Sanchez/ The Home Depot , am requesting that the above permit be renewed. I
understand that I must schedule and pass all required inspections for the permit to be finaled. Further, I
understand that this is a ONE TIME RENEWAL and the permit shall expire should I not receive a
passing inspection during any six month period during the renewal period.
Justification In order to complete installation and inspections.
OWNER/BLDR OR CONTRACTOR SIGNATURE
P.nbe r-b 5o.t�GO.t.2.Z
Print Name
tolIU 12�21
DA E
STATE OF FLORIDA
COUNTY OF tltViQ, /�,, NOV
ACKNOWLEDGED BEFORE ME THIS �L DAY OF 0C. le2r , 20 V—
BY Uulo Stand&v, WHO IS PERSONALLY KNOWN TO ME>(� , OR
HAS PROVIDED
AS IDENTIFICATION.
STATE OF FLORIDA, County of �i.—'—�"""�'
MY COMMISSION 11 IN 107517
SIGNAT OF N Y Sri ' o e� EXPIRES: March 22, 2025
Bonded Thou Notary Public Undemrllors
FOR OFFICE USE ONLY:
Number of Open Inspections:
Total Inspections:
(Divide open by total to get % of open inspections)
Percentage:
Original permit fee: x % open = $ Renewal fee
Example: [15 divided by 23=.65(%)] $175(permit fee) x .65=$113.75 (renewal fee)
Revised 7/21/2014